What Is Mild Cognitive Impairment? Can You Treat It?

Everyone loses their keys or forgets a name from time to time. Perhaps you’re forgetting to pay your bills or taking longer to perform a simple task. If these issues are becoming more of a problem for you or a loved one, it may be time to take a closer look at what’s going on. Issues with memory and functioning may be a sign of what’s known as “mild cognitive impairment” (MCI). The good news is that there are steps you can take to prevent and even reverse symptoms of MCI. 

What is mild cognitive impairment?

Your brain is constantly taking in information, processing it, and storing it in your memory for later use. Thinking, along with concentrating, remembering, judging, and problem-solving, are the actions of cognition. Cognitive impairment occurs when these processes don’t work like they normally do. MCI is one cause of these symptoms. In simple terms, MCI can refer to “early dementia” — but not all people with cognitive impairment go on to develop dementia. 

Is mild cognitive impairment normal with age?

As we age, our bodies and our minds slow down. In fact, according to the CDC, nearly 11% of people over the age of 45 reported some cognitive decline in the previous year. That might mean you forget details about an event, but you don’t necessarily forget the event itself. But for  people who have MCI, cognition issues are worse than what you would expect for their age group. At the same time, MCI is different from dementia in that people can still perform activities of daily living like cooking meals, running errands, and doing simple household chores.  

What are the symptoms of mild cognitive impairment? 

People with MCI can experience a range of symptoms. This is because there are many aspects of cognition (memory, language, concentration), and MCI doesn’t affect these aspects in the same way in different people. So while memory loss can be common, it’s not the only thing you may experience. MCI can also affect how you feel, talk, and make decisions. Symptoms may not bother some people, but others may feel very concerned. Here are some symptoms that people with MCI may notice:

• Forgetting recent events or conversations

• Losing things more than usual

• Having difficulty finding the right words when speaking

• Having problems planning or following through on tasks

Common causes of mild cognitive impairment

In some people, MCI can be the start of Alzheimer’s disease or other forms of dementia, including Lewy body dementia and frontotemporal dementia. But not all people with MCI progress to having dementia. 

In addition to dementia, there are other diseases of the brain and nerves that can cause mild cognitive impairment, such as:

• Strokes

• Neurodegenerative diseases, like amyotrophic lateral sclerosis, where nerves in the brain and spinal cord become damaged.

• Parkinson’s disease, a neurological condition that affects balance and how you move. 

Finally, there are lots of other factors that can affect cognition. Some people with MCI have an underlying cause that’s responsible for some or all of their cognitive issues. Anxiety, sedative medications (sleeping pills or anxiety medications), hypothyroidism (when you don’t make enough thyroid hormone) can all affect your cognition. But once these underlying conditions are treated — like with starting thyroid medication or stopping sedatives — memory and thinking usually improve.  

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This is why healthcare providers always check for these underlying causes when diagnosing cognitive impairment.

Who is at risk for mild cognitive impairment?

Some people have a higher risk of MCI than others. This may be because they have risk factors that increase their likelihood of developing one of the causes of MCI. Here are some risk factors that increase the risk for MCI:

• Smoking, Type 2 diabetes, and cardiovascular disease increase the risk for MCI by expanding the risk of strokes and transient ischemic attacks (mini strokes).

• Advancing age is associated with changes in the brain that can contribute to issues with cognition. 

• Having the apolipoprotein-e4 gene is the strongest risk factor for developing Alzheimer’s disease.

How serious is mild cognitive impairment?

If you start to notice problems with your memory or thinking, you may worry about what the future holds for you. That’s understandable. A diagnosis of MCI can bring a great deal of uncertainty. Take one day at a time. Not all people with MCI develop dementia, and not all people with MCI will experience symptoms the same way.  

For most, having MCI doesn’t get in the way of daily activities — but you may have to plan more carefully and get the help of friends and family members.  

People with MCI may forget names or “take the long way” to a familiar place. You may need support with higher-risk tasks such as managing finances and health. Or you may worry about staying safe behind the wheel. Your healthcare provider can help you with the decision about whether to continue driving. 

Further down the line, cognitive issues may become more frequent and start to interfere in everyday life. For example, you may forget to turn off the stove or find it difficult to brush your teeth and shower. And if this happens frequently, it can be a sign that dementia is developing.  

Getting a diagnosis of MCI: Why does it matter?  

If you or your loved one is concerned about memory or cognition, you can start by seeing a healthcare provider. They will check to see if there are clues to other medical conditions that could be affecting your thinking and memory. 

Some tests that will help your provider get to the bottom of your symptoms include:

• Blood tests may include special tests to check for lead poisoning, thyroid disease, and vitamin B12 deficiency.

• Brain scans to look for brain changes can include a CT scan or MRI. 

• Simple cognition tests include the clock test and the Mini-Mental Status Exam. 

• Comprehensive neuropsychiatric tests can confirm the diagnosis of MCI and set a baseline to track how things change over time.

A diagnosis of MCI can be scary, but it’s also an opportunity to take action. It allows healthcare providers to keep a close eye on you and look for early signs of dementia (if dementia does develop). It also allows the person affected — and their loved ones — to learn more about the condition, put in place a support network, and plan ahead.  

How fast does mild cognitive impairment get worse?

It’s difficult to predict if a person with MCI will develop dementia. It may be reassuring to know that between 5% and 15% of people with MCI will go on to develop dementia (usually Alzheimer’s disease) each year. Your healthcare provider will monitor your symptoms a few times per year to make sure your cognition isn’t getting worse.

Treatment for mild cognitive impairment

Currently there aren’t many effective treatments for MCI. Most treatments may only prevent the progression of MCI to dementia but don’t actually cure MCI. If there’s a diagnosis for an underlying cause — such as a thyroid problem, mental health disorder, or medication side effect — then treating the cause will usually help to improve memory and thinking.    

The FDA recently approved a new drug, aducanumab (Aduhelm), for the treatment of MCI and mild cases of Alzheimer's disease. But with recent reports of brain swelling occurring in up to 35% of people taking this medication, scientists are doing more research to see how safe and effective the medication is. Healthcare teams sometimes use other medications for Alzheimer's disease — such as donepezil and memantine — to treat MCI.

There’s some research that shows that special physical exercise programs and certain memory exercises may help treat MCI. But more studies need to be done to determine the benefits of these treatments for MCI. 

Is mild cognitive impairment reversible?

Yes, and reports show that about 25% to 50% of cases of MCI are reversible. It’s not clear yet why some people improve and others don’t, but there’s evidence that some activities may help reverse MCI, such as:

• Gardening

• Reading books or newspapers

• Participating in sports activities or hobbies

Prevention for mild cognitive impairment and dementia

If you’re worried about developing cognitive impairment in the future, there are some changes you can make to reduce your risk. If you already have MCI, then there are things you can do to lower your risk of developing dementia. 

Some risks, like your age and genes, aren’t things you can easily change. But there are some healthy lifestyle changes that you can embrace to keep your brain healthy: 

• Eat whole foods and do regular exercise to keep your blood pressure, cholesterol, and blood sugar levels within healthy limits.

• Get medical care for conditions that can increase your risk of heart disease and strokes, like high blood pressure, high cholesterol, diabetes, or atrial fibrillation (an abnormal heart rhythm). 

• Avoid smoking.

• Cut back on alcohol, or avoid it completely.

There are a few additional tips that experts recommend to help prevent MCI and dementia:

• Get treatment for depression.

• Minimize stress with relaxation and breathing exercises, which may help relieve stress.

• Maintain a regular routine.

• Stay organized with the help of a calendar or reminders on your phone.

• Break up big tasks into smaller, manageable steps.

• Keep your brain stimulated — read, do puzzles, and solve quizzes.

• Try to get good sleep.

• Keep up with your social life and relationships.

There are also many helpful resources for caregivers and people who have MCI and dementia. The Alzheimer's Organization is one place that provides everything from a 24-7 support line to information about local support groups.

Why trust our experts?

Written by:

David L. Miller, DO, FACOI

David L. Miller, DO, FACOI, is a retired internal medicine physician with over 20 years of clinical experience. He attended the University of New England College of Osteopathic Medicine and completed his residency in Detroit at the Henry Ford/Horizon Health System.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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